Neuromuscular Therapy

This is a great, succinct piece defining Neuromuscular Therapy (a.k.a. Trigger Point Therapy), how it works, and its benefits. Definitely worth a read!

Neuromuscular Therapy | oakworksblog.massagetables.com:

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What IS a trigger point?

Follow the link below for an excellent description of trigger points. If you think your pain is from a trigger point, find a massage therapist who practices trigger point therapy, like me!

Mending Hands - Melissa Finley Massage Therapy Park Slope Brooklyn 11215 Swedish Institute: What is a trigger point?:

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A Great Exercise to Erase Low Back Pain

Check out the following short article about correctly picking something up off the floor. And then watch toddlers as they move around. They do it all correctly - and it's all instinct. We actually get worse as we age, even though no one tells us to. Teach your kids to ignore adults in this regard and to move as they already do based on instinct - their gut feeling is right!

A Great Exercise to Erase Low Back Pain:

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Making Contact: The Right and Wrong Way to Use Exercise Machines

I am obsessed with ergonomics. It's part of being a massage therapist. So it's no surprise that every time I go to the gym, it's like nails on the chalkboard. I'm constantly seeing someone straining on the machines, just cruising for an injury. Because it's usually my husband.

He should really read this article below. It goes over the proper points of contact and stabilization needed to help prevent injury and maximize your reps. And proper alignment on the machine isn't the only thing to keep in mind. The article doesn't cover two other things to consider: Using too much weight or trying to complete your sets too fast are other recipes for injury (cough cough husband).

Making Contact: The Right and Wrong Way to Use Exercise Machines:

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Self-care for neck pain

Seven Self-Care Tips for Clients with Neck Pain

Above is the link to the full article, and I encourage you to read it as it goes into more depth on the causes of neck pain, which makes the preventive tips below make more sense. It also includes a list of references.  

1. Stress Relief - While stress will aggravate neck pain, relaxation can ease it. Suggestions for accomplishing this feat include deep abdominal breathing, meditation, visualization and other relaxation techniques.

2. Frequent Breaks - Even though sustained positions foster muscle tightness, this practice is deeply ingrained in our culture. If driving long distances or working long hours in one position, make sure to take frequent breaks. Breaks are best used to stretch, breathe deeply, take a sip of water and return to proper posture.

3. Exercises and Stretches - While some must be prescribed by a physical therapist, a massage therapist can suggest exercises and stretches for the neck as long as they don't cause pain. Exercises and stretches help reduce pain by restoring muscle function, optimizing posture to prevent overload of muscle and increasing the strength and endurance of the neck muscles. These can include shoulder blade rolls/squeezes/shrugs, cervical extension/flexion, rotation, stretching the front wall chest muscles, strengthening the shoulder muscles and isometric exercises.

4. Hot and Cold Therapy - Most practitioners suggest alternating heat and cold to help a stiff, painful neck. Reduce inflammation by applying a cold pack for up to 20 minutes several times a day. Alternate this approach with heat, either a warm shower or a hot pack, for up to 20 minutes. Heat can help relax sore muscles, but it can aggravate inflammation if the area is red, warm and swollen.

5. Evaluate Ergonomics - Adjusting home or workplace conditions to relieve unnecessary neck stress can go a long way in preventing cervical discomfort. This includes proper positioning of a desk, chair, computer and phone so the screen is at eye level, knees are slightly lower than hips, arms rest comfortably on armrests and the neck is in a relaxed neutral position while on the phone.

6. Sleep Deliberately - Since a lot of neck pain can arise from poor positioning during sleep, deliberately planning a sleep position can prevent a painful neck. Avoid sleeping on the stomach and use a pillow that supports the natural curve of the neck. Back sleepers are advised to use a rounded pillow (neck roll) under the curve of the neck, with a flatter pillow cushioning the head. Side sleepers should keep their spine straight by using a pillow that is higher under the neck than the head. The goal is to prevent overnight neck flexion.

7. Sock and Tennis Balls - A simple homemade device can be used for self-administered cervical acupressure. Put two tennis balls in a sock and tie off the sock so the balls are stationary. Place the tennis balls under the occiput (base of the skull) so they are pressing on the hollows under the skull on either side of the spine (Gallbladder 20) for about 10 minutes. Lying on this device can help relax taut, posterior neck muscles.

Bone Basics: What You Should Know About Your Skeleton

It's so easy as a massage consumer, or even as a massage therapist, to forget that muscles are only part of the body's story. With out the skeleton, muscles would be pretty useless. The skeleton and muscles fit together to make up one large system of pulleys and levers. One without the other would go no where fast. Your muscles move your bones (the pulleys); your bones provide the structure your muscles need to move (the levers). And, just like your muscles, your bones need care. They need to be strong so your body as a whole can be strong. They too need nourishment in the form of nutrition and exercise.

Read this excellent article below, and don't forget those that truly make you stand tall!

Bone Basics: What You Should Know About Your Skeleton | The Daily Muse:

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Baby, it's cold outside ...

Happy new year! I hope you had a fun, safe holiday season and wish you the healthiest, happiest year yet for 2012! I am ready to learn new things and share them.

With the new year comes even colder weather as we are now deep into winter. And that means more risk for extreme cold pathologies, such as frostbite. I'm mentioning this because something like frostbite should NOT be massaged, even though you may feel the instinct to do so.

"About Frostbite
Occurring when the skin and other tissues are exposed to very cold temperatures, frostbite can cause permanent tissue damage. Usually affecting the hands, feet, nose, cheeks and ears, frostbite can happen within minutes of exposure to extreme cold, or even in above-freezing temperatures if there is a strong wind chill or if the person is at high altitude or wet.

When exposed to cold, the body strives to preserve heat. By constricting the blood vessels near the skin's surface, blood is forced into the body's core to keep the vital organs warm. This is exactly the mechanism that prevents the extremities (such as hands and feet) from receiving enough blood, which causes them to become cold and makes them vulnerable to frostbite. The following sequence of events can lead to frostbite:

• Initially, the blood vessels alternate between narrowing and widening to keep the extremities as warm as possible.
• Under extremely cold conditions the vessels stop widening.
• When the skin's temperature drops low enough, ice crystals form around and within the cells, freezing tissue and possibly rupturing cells.
• The lack of circulation that occurs when the body directs blood flow away from the extremities can cause damage to the cells.

Frostbite Stages
There are four degrees of frostbite severity, each with their own symptoms:

1. First Degree - Known as frostnip, this affects only the skin's surface. Initial symptoms are itching and pain, and some numbness may exist. These symptoms are usually not permanent.

2. Second Degree - This level involves freezing of the skin, but not deep tissue. The affected area usually will develop blisters one to two days after cold exposure.

3. Third Degree - Possibly causing a temporary loss of use of the affected area, this level is deep enough to involve tissue, muscle and tendons. The skin turns hard and waxy and purplish, and blood-filled blisters may be present.

4. Fourth Degree - Freezing tissue, muscle and tendon, this is the most severe stage of frostbite. The affected area suffers permanent loss of function and is at risk for possible amputation due to infection.

In general, the indications of frostbite are:

• Itching, pain or prickling progressing to numbness
• Pale, hard, cold skin with a waxy appearance
• Flushing from blood rushing to the area after being re-warmed
• Burning sensation and swelling from collected fluid that can last for weeks

Medical help should be sought right away to prevent permanent tissue damage, as the extent of the injury may not be apparent until the area is re-warmed. If medical care is not available immediately, a mildly frostbitten area can be warmed in warm water (101 - 104° F), or by repeatedly applying warm cloths to the area for 30 minutes. Never use hot water, fire, a heating pad, or other dry heat because these methods may burn the skin before the feeling returns. Because the affected area may swell, remove any jewelry before re-warming. You can also give the person with frostbite something warm to drink (no alcohol or caffeine). If the toes are the frostbite culprit, help the person ambulate without them putting pressure on their feet. If there is any danger of refreezing, wait to thaw the area out until warm shelter is guaranteed. Thawing and refreezing can cause even more serious damage to tissue.

Warming should be done without applying movement to the tissue. That means no rubbing, massaging or shaking. Excessive movement will cause the ice crystals to injure sensitive body tissue."

Source: What Massage Therapists Should Know About Frostbite

As always, the best game plan is prevention. Remember your hat, scarf and gloves before going outside. Even if you don't think you'll need them, pack them in your bag, or stuff them in your pockets. It may be 50 this Saturday, but only in the middle of the day. Winter temperatures can drop dramatically in short periods. And if you suspect frostbite, please follow the instructions above.

Stay safe out there!

Massage in the News

Interesting article from the Washington Post:

Alternative therapies almost always pay off 

Hospitals offer these treatments not only because they work, but also because they attracts patients. Who knew?

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Are You Stretching the Wrong Way? Try the Right Way

Below is a link to a well-written article regarding stretching. It is worth a look, especially if you are worried you might be over doing it with your stretching routine, or if you are confused by the conflicting ideologies of stretching versus not stretching before a workout. Some experts believe that stretching before a workout prevents injury; others believe that the long hold stretches most people are taught can actually cause injury (an increasingly accepted idea). The AIS method of stretching bridges the two camps with a different way of thinking.

Are You Stretching the Wrong Way? Try the Right Way:

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Sciatica & Massage

If you have sciatica, or leg pain, consider massage therapy. It's such a natural, relaxing way to find relief!

Remember, though, that sciatica is a symptom of something else, and not a medical condition itself. It simply refers to leg pain, numbness or tingling caused by compression or injury to the sciatic nerve, the largest nerve(s) in our bodies. (We have one on each side; they start at the end of our spinal column and run through our hips and down our legs.)

Compression of the sciatic nerve is sometimes due to tense musculature. Hmmm ... what could help relieve tense muscles, I wonder?

Read this good blog post. Sarah Minen, LMT describes it quite well and has a clear illustration: Sciatica Massage Salt Lake City, Utah | Sarah Minen LMT - Salt Lake City Utah Massage Therapy.

For more information on sciatica itself, click here.

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Glossary of Massage and Bodywork Techniques

First: I did not feel the earthquake. I was in the backyard playing with my dog when I heard a rumble and a rattle that must have been my gutters/porch/entire house. I thought it was weird, and my dog heard it too. I don't think he felt it. We just looked at each other and I shrugged. I'll bet he would have, too, if he could. Then I quickly forgot about it. Just a few minutes later I got a call from my mom, whose first words were, "Are you okay?" Um, what? She felt it in Pittsburgh. But we're all okay here at the Haddock house. I hope you are, too.

Second: Follow the link below for a great resource on different bodywork modalities, from the popular to the obscure. I haven't even heard of half of them. Enjoy exploring!

Glossary of Massage and Bodywork Techniques

Low Back Pain: Five Tips for Massage Therapy Clients

Massage therapy has been a coveted way to relieve low back pain for as long as historical documents on the subject exist. However, a new study commands an even greater level of respect for massage's effectiveness at helping this problem. As published in a July 2011 edition of the Annals of Internal Medicine, a study funded by the U.S. National Center for Complementary and Alternative Medicine evaluated the effectiveness of massage therapy for chronic low back pain.

In this study, over 400 participants with chronic low back pain either received weekly whole-body massages for relaxation, weekly massages that focused on specific muscle problems around the lower back and hips, or usual care. Those receiving usual care typically took pain medications or muscle relaxants, saw doctors or chiropractors, received physical therapy or simply did nothing. The researchers found that both types of massage therapy were much more effective at relieving low back pain than usual care. After 10 weeks of intervention, the following was reported:

• 36 percent of patients receiving weekly whole-body relaxation massage said their pain was nearly or completely gone.

• 39 percent of patients receiving weekly massage that focused on specific muscle problems around the lower back and hips said their pain was nearly or completely gone.

• Just 4 percent of patients receiving usual care said their pain was nearly or completely gone.

Tips to Prevent Back Pain
Massage therapy's ability to relieve back pain is rarely disputed, but therapists can also help their clients prevent low back pain recurrence. The following suggestions can help prevent low back pain from returning:

1. Quit Smoking - Smoking cigarettes seems to worsen just about every known health condition, including low back pain. Likely because smoking hinders blood circulation, experts assert that smokers are 30 percent more likely to suffer from back pain than non-smokers.

2. Get Up and Move - Whether behind a wheel, in front of a computer or just watching TV, sitting for extended periods of time is one of the worst positions for the low back. The spinal discs are spongy and cushion the vertebrae, but they naturally have poor blood supply. Upon getting up and moving, fluid circulates around the discs. On the other hand, sitting starves the discs of fluid making them vulnerable to damage.

3. Stretch and Strengthen Core Muscles - Most physicians agree that regular stretching and strengthening of the core muscles constitute the most important lifestyle practices for preventing back pain. Advise clients in a safe stretch and strengthen program with a focus on back, abdominal, oblique and leg muscles.

4. Lift Properly - Those who lift heavy objects for a living are well aware of the importance of body mechanics, but the rest of us may not be. Always engage abdominal muscles during a lift, bend the knees, keep back straight, don't bend at the waist, keep object close to the body, do not hold an item higher than armpits or lower than knees, don't move something over 20 percent of your body weight, don't pivot, twist or turn while lifting, point feet at the item being lifted, and only change direction with the feet (not the waist). These instructions will help prevent back muscles from being strained.

5. Wear Back-Friendly Shoes - Supportive, low-heeled or flat shoes are crucial for preventing back injury. Although high heels may be high fashion, they increase the arch in the low back. This spinal alignment change increases one's susceptibility to low back injury.

Source:

Low Back Pain: Five Tips for Massage Therapy Clients

Are You Dehydrated?

A trip to the loo is a clue! This is a great blog post on easy ways to determine if you are dehydrated, and how to get and stay hydrated if you are.

Be sure to check out the refreshing lime and cucumber spritzer recipe as well. It's super easy, actually: a bit of lime juice and club soda or seltzer over some ice with a few thin cucumber slices. I plan on drinking it all summer long!

first sign of dehydration - Simply Stated Blogs | Real Simple

Less Stress Could Lead to Weight Loss

Check out this interesting article on stress and weight loss. While it points out that massage therapy induces relaxation and reduces stress, it doesn't mention studies that have shown massage to reduce the stress hormone cortisol for up to two weeks.

Less Stress Could Lead to Weight Loss

Are you breathing correctly?

Most people don't breathe correctly. It seems odd, since it's an automatic function that you don't even think about. But therein lies the problem. Most people don't think about how they breathe, and thus they don't breathe correctly at least part of the time.

Breathing with your diaphragm, or belly breathing, maximizes the exchange of oxygen in the lunges. Oxygen is what makes us clear-headed, alert and energized. Most people assume they need to breathe from their chest. This can lead to the tension people feel in their chest, neck, shoulder and upper back, not to mention foggy-headed.

When I tell a client to take a deep, slow breath, I pay attention to how and where they are doing it. If they inhale quickly and sharply with their chest, I encourage them to try again, but by expanding the belly slowly to breathe in, and to contract the belly to push the air back out.

This article goes into further detail about proper breathing. Please check it out and be mindful of your breath!

Self-Care for Back Pain: Exercises to Help the Healing Process

Spotted on the Galactic Interweb! I wanted to share as this is an excellent practical application for back pain care that you can do at home.
~Stephanie 

Original Source:

To Your Health May, 2010 (Vol. 04, Issue 05)

By Marc Heller, DC

When it comes to back pain, your first thoughts may be to take over-the-counter pain medication and rest whenever possible. Two bad options. First, medication is only going to temporarily relieve the pain, if at all, and may be accompanied by various unpleasant side effects attributable to drugs. Second, rest may actually hurt more than help. While you're seeing your chiropractor, there are a few things you can do at home to help the healing process. Believe it or not, it's based on the simple principle of movement.

Whenever I see a patient with back pain, I always ask, "What do you do when you are in pain? What exercises help your pain?" I am continually surprised that very few patients know what self-care to do when they have an acute episode of pain. That includes motivated patients and patients I have seen before and carefully shown the right exercises. Maybe it is because when you hurt, you stop thinking clearly; or maybe it is fear that the pain will get worse. Both are valid excuses. Most of them just rest, ice the area, and use non-steroidal anti-inflammatory drugs (without realizing that NSAIDs actually block healing). Many of them say, "I hurt too much to exercise."

Why Movement Matters
The problem with this is that when you stop moving, when you are still, everything tightens up, circulation slows down, and pain chemicals accumulate in your muscles and joints. It's like waking up after sleeping in a cold room on a lousy mattress with a draft. If you get moving, you'll typically start to feel better.

So, here's the number-one rule to remember: Don't stop moving when you hurt. I know, you are in pain and afraid to move, and sudden movements may cause your back to "grab" or spasm. I am not telling you to ignore the pain. What I am saying is that you need to find movements that will ease your pain. In many cases, the most important thing to do when you hurt is to keep moving. The body often tightens up and limits your motion. If you find a motion that doesn't hurt you, it will probably help you. When you are hurting, you may not be able to do your usual activities, but you must keep moving. Try walking slowly, especially on flat and even ground. Try walking up a hill (you can walk up a hill without walking down, on a treadmill). Try swimming or simple motions in chest-deep water. Try basic pelvic tilts, staying within a pain-free range.

Here are some basic principles. The movement should be pain free (or at least cause minimal pain while being performed). When you have finished doing the exercise, your pain should be somewhat diminished. You should feel that you can move more freely. Your back should feel straighter and less "kinked."

Backward bending is a great exercise when you're suffering from low back pain. Start on the floor or other stable surface (top picture), then slowly raise your upper body up while keeping your lower body stationary (bottom picture). The final step involves extending your arms up (much like a push-up). Basic Exercises for Low Back Pain
Here are two basic examples of self-care exercises that have stood the test of time. Many of my patients have found variations on these and other types of movements that act as "reset" buttons for their typical pain. You are the one living in your body; you are the most likely one to know what is working for you.
Lower back diagnosis is often very difficult and confusing. For the sake of this article, let's divide low back pain exercises into two categories: exercises that make your back feel better when you bend backward, and exercises that make your back feel better when you bring your leg toward your chest.

Backward Bending (extension of the lumbar spine). An exercise called the McKenzie extension is the first thing you should try if you have sciatica (pain running down your leg). If these exercises work, your pain will diminish and may centralize, which is a good thing. Centralize means your pain goes less far down your leg, and you may feel it closer to the spine. Bending backward may not feel good at first, but you should feel better immediately afterward. If you feel worse afterward or the pain goes farther down your leg, stop, as this is not the exercise for you.

How to Do It: Lie face-down on the floor, arms bent at your sides (sort of like a starting push-up posture). Straighten your arms up slowly, lifting your upper body off the floor as you do so.

Your legs and feet should stay on the ground. Hold for 3-5 seconds, then slowly lower your upper body back down. Repeat 10 times, as often as once per hour.

If your pain or restriction is on one side, a variation on McKenzie extension (lying on a raised surface with one leg on the floor, slightly bent) may be more comfortable (keep the elevated leg straight).


Flexion Exercises (bringing the leg toward the chest). People with lower back pain can also feel better with various types of leg flexion, bringing the bent leg toward the chest, or doing contract-relax and then bringing the bent leg toward the chest. These people usually have sacroiliac joint problems. (The SI joints are located on either side of the spine in the lower back.) These are also called Tigny exercises.

How to Do It: Lie on your back with one leg bent and then other flat on the floor. Bring the bent leg up toward the chest. Wrap your arms around the leg and then try to lower it toward the floor for 3-5 seconds, resisting with your arms. Relax, and then pull the bent leg up farther toward the chest. Repeat the entire process three times.

Flexion exercises are another great way to relieve lower back pain. Lie on your back with one leg bent and the other leg flat on the floor. Raise the bent leg toward the chest, wrap your arms around the bent leg, and then try to lower it toward the floor as you resist with your arms. Repeat with the opposite leg. I have included a series of links at the end of this article; the first two go to videos describing the basics of McKenzie extension. The third one goes to an article I wrote describing the basic McKenzie extension exercise, and a couple of other variations. The fourth link goes to Dr. Craig Liebenson's site, LA Sports and Spine, where you can download his article and pictures on McKenzie self-treatment for sciatica. The fifth and sixth links relate to the Tigny flexion exercises, including a one-minute video demonstration.

So, here is the bottom line: When your lower back starts to hurt, find one or more simple movements or exercise that helps. Do the exercise over and over until you are back to normal. If you are not getting better quickly, call your chiropractor.

With that said, please use common sense. Stop immediately is you hurt more during or after doing any exercise. Exercise is not without risks. These or any other exercises may cause pain or injury. As with any exercise program, if at any point during your routine you begin to feel faint, dizzy, or have physical discomfort, you should stop immediately. To reduce your risk of injury, consult with your doctor before doing these exercises for the first time, particularly if your pain is new and/or you would like further explanation of how to perform the exercises correctly.

Links to Exercise Demonstrations and More Information

• Video of McKenzie lumbar extension.
• Sciatica self-care, by Dr. George Best, six-minute video.
• "Pain-Relief Exercise: The Lower Back."
• See the McKenzie self-treatment for sciatica; the other exercises are also useful.
• "Sacroiliac Joint Correction - A Different Model." A description of the Don Tigny model of the SI, with pictures of his various exercises.
• Video of flexion exercises.

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Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore. He is a nationally recognized expert in treating tailbone, sacroiliac and lower back pain.

How to Get the Best Massage

Spotted on the galactic interweb! I wanted to share this - it's sage advice.
~Stephanie 
 

By Susannah Felts
From Health magazine

Massage isn’t just a me-time indulgence. Studies show it reduces stress, boosts immunity, and relieves pain from everyday wear and tear. And in tough times, just 30 minutes on the table (or even 10 minutes in a chair) can go a long way toward working out your kinks—as long as you make sure your needs are met. Here’s how to get your money’s worth.

Find the right therapist
Just as you would with an MD, select a certified massage therapist who meets your specific needs, whether you’re looking to soothe post­mara­thon aches or relieve a stiff neck. General certification in Swedish massage—long, sweeping strokes over the entire body—fits the bill when you’re simply looking to relax. (Swedish is what you’ll get if you ask for a basic massage; Shiatsu, or acupressure, features more targeted finger pressure in specific areas.) Go here to find the most experienced certified massage therapists in your area.

Speak up!
Before the massage begins, mention any areas of your body that are feeling sensitive, tight, painful, or tender (like a knot in your neck or an achy spot in your shoulder); these should be treated with particular care, according to Leena Guptha, an osteopathic doctor, a licensed massage therapist, and past president of the American Massage Therapy Association.
Most massage isn’t painful, though moderate pressure—which studies have found is necessary to provide optimal therapeutic benefits—may feel a little uncomfortable, especially if you’re new to massage. Is the pressure too intense? Don’t be shy. Guptha suggests saying something like, “That really hurts. Can you try something different or skip this area?” A good therapist should welcome (or even ask for) your input.

Pick your products
It’s acceptable to bring your own lotion or oil, especially if you have sensitive skin, a sensitive nose, or a condition like eczema or psoriasis. Another option: Ask the therapist to show you her product stash and discuss the options (many are fragrance-free). “There are dozens available for different types of massage, and your therapist should have a variety to choose from,” Guptha says.

Reschedule if you have a cold
“Postpone your massage if you feel a cold or migraine coming on,” Guptha says. “The massage will stimulate your circulation, which could leave you feeling worse.” If you’re a little stuffy or just find it difficult to breathe when lying face-down, ask to lie on your side. An experienced therapist can perform most techniques this way, or she can work on your upper back, neck, and shoulders while you’re in a sitting position.

Period? No problem
There’s no medical reason to avoid a massage during your period, Guptha says. In fact, it can ease PMS symptoms like cramps and backache. But if you’re worried about heavy bleeding, just wait a few days.